How Much Does LDRT Cost Without Insurance?

Here is the honest answer first: as of September 2026, we could find no US program that publishes a self-pay price for a full LDRT course for arthritis. Any website that quotes you a single dollar figure for LDRT is guessing. This page explains why one price does not exist, what the published literature does say about cost, and how to get a real number from a program before you commit.

Why There Is No Single Price

A course of radiation therapy is not one charge. It is billed as separate components: a consultation with the radiation oncologist, simulation (the planning session), then each treatment delivery, then follow-up^[1]. Each component has its own billing code. Simulation is coded 77280, 77285, or 77290 depending on complexity^[2]. Treatment delivery is coded per session as 77402, 77407, or 77412. Superficial and orthovoltage treatment, which some LDRT programs use, has its own codes starting in 2026: 77436 through 77439, covering planning, delivery, and image guidance^[3][4].

The same codes pay different amounts in different places. Medicare's fee schedule sets separate prices for hospital and freestanding-center settings, and adjusts by geographic area^[5]. A typical LDRT course runs: initial consultation, a CT scan for planning, six treatments of 0.5 Gy two to three times a week over two to three weeks, and a reevaluation around three months^[6]. Six sessions in a hospital outpatient department in one city simply do not cost the same as six sessions at a freestanding center in another.

What the Literature Says About Cost

A 2022 review described LDRT as a "low-cost, noninvasive treatment with few side effects," citing trials showing moderate to long-term pain reduction and better mobility^[7]. The American Radium Society's 2026 guideline notes "renewed and growing interest in the use of LDRT as a cost-effective treatment for OA"^[8].

Read those as characterizations, not measurements. No published formal cost-effectiveness analysis of LDRT for osteoarthritis versus surgery or injections exists. Cost-effectiveness studies comparing low-dose radiation with injections are still planned, not yet published^[9]. "Low-cost" here means inexpensive relative to an operation, which is a low bar, not a price you can budget around.

How to Get Your Real Number

• Ask the program for the billing codes and a written estimate. Under the No Surprises Act, uninsured and self-pay patients have the right to a written Good Faith Estimate before scheduled care, delivered within 1 to 3 business days of scheduling or asking^[10].
• Check the hospital's published prices. Since 2021, federal rules require every US hospital to publish its standard charges in a machine-readable file plus a consumer-friendly list of at least 300 shoppable services, including discounted cash prices^[11]. Compliance is incomplete, about half of hospitals in a September 2026 review, so you may need to call the billing department directly^[12].
• Ask about a self-pay or cash discount, and get the quote in writing with the codes on it.
• Know your backstop: if the final bill is at least $400 more than your Good Faith Estimate, you can dispute it through the federal dispute process^[10].

One program, Advocate Radiation Oncology, states that "Medicare and most major insurance providers cover the cost of LDRT"^[13]. If you have coverage, our insurance and Medicare pages explain how to check your own plan before assuming anything.

References:
1. UT Southwestern Medical Center. Radiation Oncology Treatment Guide (patient guide describing consultation, simulation, and treatment billing components). Guide (PDF)
2. NIA / Evolent. Simulations - Radiation Oncology Coding Standard 2024 (77280 simple, 77285 intermediate, 77290 complex). Document (PDF)
3. UnitedHealthcare. Radiation Therapy: Fractionation, Image-Guidance, and Special Services (provider medical policy; treatment delivery 77402/77407/77412). Policy (PDF)
4. American Association of Physicists in Medicine. 2025 Annual Meeting Presentation of Medicare 2026 Proposed Rule (2026 CPT codes 77436-77439 for superficial/orthovoltage delivery). Presentation (PDF)
5. Centers for Medicare and Medicaid Services. Search the Physician Fee Schedule (public lookup by CPT code; facility vs. non-facility and locality pricing). CMS tool
6. Low-Dose Radiation Therapy Making a Comeback for OA. Medscape. 2025. Article
7. Comprehensive review of LDRT for osteoarthritis citing Dove et al., Int J Radiat Oncol Biol Phys. 2022;114:203-220. Review (PMC)
8. American Radium Society Appropriate Use Criteria for Use of Radiotherapy for Treatment of Osteoarthritis. Expert Panel for Use of Radiotherapy in the Treatment of Arthritis. 2026. Full guideline document. Full document (PDF)
9. Low-dose radiation shows promise for painful knee osteoarthritis. ASTRO 2025 coverage noting planned cost-effectiveness studies. Knowridge
10. The Corvallis Clinic. Notice of Patient Rights to Good Faith Estimate (No Surprises Act; $400 dispute threshold). Notice
11. Centers for Medicare and Medicaid Services. Hospital Price Transparency FAQs (machine-readable file and 300 shoppable services, including cash prices). CMS FAQs (PDF)
12. Hospital price transparency compliance improves but lags at 49%. TechTarget, citing PatientRightsAdvocate.org. TechTarget
13. Advocate Radiation Oncology. A Low-Dose Solution for Osteoarthritis ("Medicare and most major insurance providers cover the cost of LDRT"). Program page